Key result
Male sex is linked to higher non-rheumatic degenerative mitral valve disease rates and slower mortality declines.
Why the study?
Considerable sex-specific differences exist regarding etiology, pathophysiology, and outcomes across valvular heart diseases, but sex-specific and worldwide patterns in non-rheumatic degenerative disease burden had not been explicitly described.
The global burden of non-rheumatic degenerative mitral valve disease remains heavy, particularly in elderly males and high-income regions, despite overall declines in mortality and DALY rates since 1990.
Sex differences in degenerative mitral valve disease burden may inform targeted surveillance in males; leaves open causal mechanisms and regional disparities.
Objectives: Considerable sex-specific differences regarding etiology, pathophysiology, and outcomes across valvular heart diseases exist. This study aimed to explicitly describe sex-specific and worldwide patterns in the non-rheumatic degenerative disease burden. Methods: Using the Global Burden of Disease 2021 (GBD 2021), incidence, prevalence, deaths, and disability-adjusted life years were adopted to assess the burden of non-rheumatic degenerative disease. Global, regional, national, and age-period-cohort analyses, focusing on sex-specific sub-analysis, were performed between 1990 and 2021. Results: Globally, significantly higher age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) in 2021 were observed in males. Both ASIR and ASPR remained relatively stable or slowly declining but both the age-standardized mortality rate and age-standardized disability-adjusted life year rate rapidly declined (net drift < -1.0%) during 1990–2021. More reduction and more rapid decline of ASIR and ASPR were noted in females. Regionally, males had higher ASIR and ASPR across socio-demographic index quintiles, except in the low socio-demographic index region. In females, more reductions with more rapid decline were observed in middle and low-middle regions regarding the age-standardized mortality rate and observed in high, high-middle, middle, and low-middle regions regarding age-standardized disability-adjusted life year rate. Nationally, significant sex-specific differences between four age-standardized rates and net drifts were found in many countries like Norway, Grenada, Ethiopia, and American Samoa. The sex-specific age patterns of the four indicators also varied, commonly heavier in the middle-aged elderly male population. In the age-period-cohort model, males showed poorer performance in the age, period, and cohort effects. Conclusion: Various and heterogeneous sex-specific patterns in non-rheumatic degenerative disease burden were characterized spatiotemporally in detail. Despite great advancements, the burden remained heavy, particularly in high-income regions or countries, and elderly. These findings would be beneficial for healthcare professionals, policymakers, and researchers to precisely refine strategies on management and healthcare source allocation targeting sex-specific patterns.
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Ma et al. (2026) studied this question. Males had higher incidence and prevalence rates of non-rheumatic degenerative mitral valve disease globally in 2021, with females showing faster declines in mortality and disability rates.
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